Yang Zhi-rong, Bi Cheng-feng, Zhang Wen-yan, Yang Qun-pei, Liu Wei-ping
Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, China.
Zhonghua Bing Li Xue Za Zhi. 2013 Sep;42(9):589-92.
To investigate the clinicopathologic features, immunophenotype, diagnosis and differential diagnosis, and prognostic factors of testicular diffuse large B-cell lymphoma (DLBCL).
The clinical and pathologic profiles of 58 cases of testicular DLBCL were investigated.Immunohistochemical stainings and EBER1/2 in situ hybridization were performed on formalin fixed tissues.
The average age of the patients was 62.1 years, and the median age was 65 years. The course of disease was short in most of the cases. Clinical stages at diagnosis were mainly stage I or II (87.9%, 51/58). Forty eight patients (82.8%) had unilateral testis involvement. Inguinal lymphadenopathy was observed in 12 (20.7%) patients and the other organs were seldom involved. Morphologically, centroblast-like neoplastic cells infiltrated interstitial tissue of testis diffusely and invaded into seminiferous tubules. Tunica albuginea and vessels were involved in 14 (24.1%) and 10 (17.2%) patients, respectively. Immunophenotype analysis showed predominant non-GCB type of DLBCL (48/58, 82.8%) by Hans classification. No EBV infection was detected. Follow-up data were available in 48 (82.8%) patients. Twenty eight patients (58.3%) died of the disease. One-year, 3-year, and 5-year overall survivals were 55.7%, 31.6% and 27.6%, respectively. Age (older than 60 years), B-symptoms, high serum level of LDH, advanced Ann Arbor stage as well as lack of combination of therapy were associated with a poor prognosis.
This large series of testicular DLBCL mainly present with local disease at diagnosis. Most cases show non-GCB immunophenotype. Despite early clinical stage at presentation, the prognosis is poor. Combined chemotherapy postoperation may prolong survival of the patients.
探讨睾丸弥漫性大B细胞淋巴瘤（DLBCL）的临床病理特征、免疫表型、诊断与鉴别诊断及预后因素。
对58例睾丸DLBCL的临床和病理资料进行研究。对福尔马林固定组织进行免疫组织化学染色及EBER1/2原位杂交。
患者平均年龄62.1岁，中位年龄65岁。多数病例病程较短。诊断时临床分期主要为Ⅰ期或Ⅱ期（87.9%，51/58）。48例（82.8%）患者为单侧睾丸受累。12例（20.7%）患者出现腹股沟淋巴结肿大，其他器官很少受累。形态学上，中心母细胞样肿瘤细胞弥漫浸润睾丸间质组织并侵入生精小管。白膜和血管受累分别见于14例（24.1%）和10例（17.2%）患者。免疫表型分析显示，根据Hans分类，DLBCL以非生发中心B细胞（GCB）型为主（48/58，82.8%）。未检测到EB病毒感染。48例（82.8%）患者有随访资料。28例（58.3%）患者死于该病。1年、3年和5年总生存率分别为55.7%、31.6%和27.6%。年龄（大于60岁）、B症状、血清乳酸脱氢酶（LDH）水平高、Ann Arbor分期晚期以及缺乏联合治疗与预后不良相关。
这一大组睾丸DLBCL在诊断时主要表现为局部病变。多数病例显示非GCB免疫表型。尽管初诊时临床分期较早，但预后较差。术后联合化疗可能延长患者生存期。
